7. CMS-10275. Attachment D.2_2ndEnglishSurveyCoverLetter_(final rule)

Sample Cover Letter for Second Questionnaire Mailing to Mail Survey Nonrespondents
Home Health Care CAHPS Survey
To be Printed on Home Health Agency or Vendor Letterhead
«FirstName» «LastName»
«Address1» «Address2»
«City_Name», «State_Code» «Zip_Zip4»

«MailDate»

Dear «FirstName» «LastName»:
You recently got a survey from Medicare about your experiences with «HHA». If you already
sent this survey back, thank you! You don’t need to do anything else.
This is a friendly reminder that we’re very interested in learning about your experiences. Your
feedback will help others choose a home health care agency and will help Medicare improve the
overall quality of home health care.
Please take a few minutes to complete and return
the survey in the postage-paid envelope included.
Your voice matters. We know your time is valuable.
Participation is voluntary, and your information is kept
private by law. No one can connect your name to your
answers.

We care about your care
experiences.
If you need help with the survey,
please ask a family member or
friend.

For questions about this survey, please call VENDOR
NAME, (toll-free) at 1-XXX-XXX-XXXX.
Thank you for helping to improve home health care.
Sincerely,
Name
Home Health Agency Administrator

[PRINT SAMPLE ID HERE]

Si tiene preguntas o desea recibir la versión de la encuesta en español, por favor llámenos al
número que aparece arriba.